296 THE VITAMINES 



and was accompanied by beriberi symptoms (heart dilatation). In 

 individual cases, anasarca, serous fluids in the pericardium, pleura and 

 peritoneum were noted symptoms which belong sometimes to 

 both scurvy and beriberi. Greig (I.e. 880) also observed, in cases of 

 epidemic dropsy, scorbutic symptoms, with bleeding of the gums in 

 10 per cent of the cases. Gouzien (909) described an interesting 

 picture of a disease in Hanoi. At first beriberi developed; if white 

 rice was then replaced by the hand-milled variety, the entire 64 

 patients promptly recovered, only to develop scurvy somewhat later. 

 The cases of scurvy which develop on decorticated corn in South 

 Africa are explained with some difficulty. Fleming, Macaulay and 

 Clark (910) reported thousands of such cases among miners in South 

 Rhodesia. The composition of the diet there was as follows : Mealie- 

 meal (a corn product poor in vitamine B) 2 pounds daily; meat 1 

 pound weekly; beans 2 pounds weekly; and nuts (monkey-nuts) 

 If to 2 pounds weekly. Orenstein (911) is of the opinion that the 

 differential diagnosis of beriberi and scurvy in these cases was not 

 made properly; he could, however, firmly establish the point that 

 these diseases promptly disappear on giving fruit and vegetables. 

 Darling (912) regarded this South African disease as scurvy, whose 

 picture was complicated by beriberi. Among the pathological find- 

 ings, there was noted hypertrophy of the right heart, fatty degenera- 

 tion of the heart musculature and the vagus, in addition to accen- 

 tuated reflexes. In a later contribution, Darling (913) stated that 

 scurvy at the Rand mines can not be so easily cured as pure scurvy, 

 and it was therefore regarded as a mixed form. 



What we wish especially to establish by these statements is the 

 fact that we encounter in beriberi, as well as in other human avitam- 

 inoses, a pathological condition which perhaps can not be regarded 

 as being entirely due to the lack of a single vitamine. 



